Author Question: CXR examination: Determines fluid status in lungs. Rule out atelectasis, pneumonia, collapsed lung, ... (Read 66 times)

vicotolentino · **on:** Jun 25, 2018

CXR examination: Determines fluid status in lungs. Rule out atelectasis, pneumonia, collapsed lung,
pneumothorax.
ECG: Determines rate, rhythm, and ST-T wave changes indicating ischemia and right ventricular
strain.

Why would the physician order ABGs on room air as opposed to with supplemental O2?
What will be an ideal response?

Question 2

H.K. is taken to surgery for open reduction and internal fixation (ORIF) of the tibia and fibula fractures. He
returns with a full-leg fiberglass cast with windows over the areas of surgery.

Describe the assessment of a patient with a long leg cast involving trauma and surgery.
What will be an ideal response?

kaillie · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

The physician wants to evaluate M.M.'s basic pulmonary status. This will help determine the need for
spiral computed tomography (CT) scan of the lungs or other testing for PE.

Answer to Question 2

The five Ps should be assessed, paying special attention to capillary refill, temperature, color,
movement, and sensation of toes.
Assess tightness of cast at edges because continued swelling might result in tightening of the cast
and compartment syndrome.
Assess for increasing or excessive pain because these might indicate infection or ischemia.
Assess drainage on the cast by drawing a line around edges of drainage at regular intervals.
Although fiberglass casts allow for better ventilation than plaster casts, a cast still covers large
areas of skin. Assess odor of cast. Foul odor may indicate infection.